Objectives The aim of this study was to compare the effects of two margin designs (shoulderless and slight chamfer) with two occlusal thicknesses on fracture resistance and failure mode of the monolithic zirconia crowns. Materials and Methods Forty nickel–chromium dies were duplicated from the previous two prepared teeth using a three-dimensional optical scanner. Nickel–chromium supporting dies were divided into two main groups (n = 20) according to the type of margin design: group A, slight chamfer margin design and group B, shoulderless margin design. These groups were further divided into two subgroups according to the occlusal thicknesses (0.5 and 1 mm). The digital imaging of each die was done using a three-dimensional optical scanner, then zirconia blocks were milled by 5-axis machine. The crowns were cleaned by alcohol, air dried, and cemented by resin cement. Next, the crowns were subjected to 500 hot and cold cycles (30 seconds for each cycle). The samples were subjected to a static load until failure using an electronic universal testing machine and fracture resistance was recorded in Newton (N). Statistical Analysis Data were analyzed using the test of normality (Shapiro–Wilk test) and two-way analysis of variance (ANOVA) test. Results The highest mean fracture load was recorded by the shoulderless (1 mm occlusal thickness) subgroup (3,992.5 N), followed by shoulderless (0.5 mm occlusal thickness) subgroup (3,244.4 N), and the slight chamfer (1 mm occlusal thickness) subgroup (2,811 N). The lowest mean of fracture load was recorded by slight chamfer (0.5 mm occlusal thickness) subgroup (1,632.9 N). The two-way ANOVA test revealed a significant difference between the four subgroups. Regarding the fracture mode, the slight chamfer subgroups showed a severe fracture of the restoration while the shoulderless subgroups showed a fracture through the midline of the restoration. Conclusion Within the limitation of the comparative study, shoulderless margin design has a more favorable outcome than a slight chamfer design in all thicknesses. Although the restoration with reduced occlusal thickness has lower fracture resistance than 1 mm occlusal thickness, the 0.5 mm restorations still can tolerate occlusal forces.
Several factors can directly damage dental pulp. Pulp healing requires controlled inflammation, which can be directed through specialized medical materials to eliminate infection and promote pulp repair. This review aimed to categorise these materials and identify their histological and molecular effects on pulp tissue or isolated cells in culture. In addition, we sought to identify which of these materials could trigger a favourable inflammatory pathway that could direct the pulpal response toward healing and regeneration. A single database (PubMed) was used, and the search strategy was based on MeSH terms. The search was conducted for articles published in English between January 2010 and December 2023, including those with histological and molecular findings. Only 33 articles met our inclusion criteria. Several conventional pulp capping agents have been shown to induce pulp healing and repair through dentine bridge formation. These materials show varying degrees of inflammation, ranging from moderate to mild, which may diminish over time. Other experimentally developed materials were also studied, either alone or in combination with conventional products; these materials demonstrated promising potential to reduce inflammation and superficial necrosis associated with conventional products. However, they still do not meet all the criteria for ideal pulp-capping materials and need further development for commercialisation. Several inflammatory pathways were also addressed in this review, along with favourable tissue responses to induce pulp regeneration. The immunomodulatory role of M2 phenotype macrophages is currently the most accepted, though the lack of standardised experimental procedures across studies hinder precise decision-making.
Hydrogels are hydrophilic biocompatible polymers that can be used as a drug delivery material in different medical branches, including vital pulp therapy. The aim of this study is to characterize the physical and biological properties of the newly developed formula as a candidate direct pulp-capping material. The hydrogel composite was prepared from natural and synthetic origins (polyvinyl alcohol (PVA), hyaluronic acid (HA), and sodium alginate (SA)) with the incorporation of bioactive Moringa. Different formulas of hydrogel containing different concentrations were evaluated for physicochemical (FTIR, XRD, SEM, degradation, and swelling), mechanical (viscosity, folding endurance, film thickness), and biological (antioxidant, antibacterial, and cytotoxicity) properties. FTIR and XRD confirmed successful incorporation and partial cross-linking between moringa and hydrogel compounds. At low concentrations of moringa, the hydrogel formula showed integrity, scavenging activity, and homogeneity. The moringa-loaded films showed concentration-dependent antioxidant and antibacterial properties, especially at higher concentrations, with acceptable cytocompatibility. The low concentration of moringa (0.5%) may be considered a promising candidate as a novel pulp-capping agent supporting tissue healing and regeneration.